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1114206042 NPI number — CONNIE BEIRO FREEMAN NNP

NPI Number: 1114206042
Health Care Provider/Practitioner: CONNIE BEIRO FREEMAN NNP

Information about “1114206042” NPI (CONNIE BEIRO FREEMAN NNP) exists in 1114206042 in HTML format HTML  |  1114206042 in plain Text format TXT  |  1114206042 in PDF (Portable Document Format) PDF  |  1114206042 in an XML format XML  formats.

NPI Number : 1114206042 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1114206042",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FREEMAN",
    "FirstName": "CONNIE",
    "MiddleName": "BEIRO",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "NNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BEIRO",
    "OtherFirstName": "CONNIE",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "800 BRADBURY DR SE STE 116",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBUQUERQUE",
    "MailingAddressStateName": "NM",
    "MailingAddressPostalCode": "87106-4310",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "505-272-1476",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1000 E MOUNTAIN BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WILKES BARRE",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "18711-0027",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "570-808-7300",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/09/2011",
    "LastUpdateDate": "02/18/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2080N0001X",
          "TaxonomyName": "Neonatal-Perinatal Medicine Physician",
          "LicenseNumber": "101-0134470",
          "LicenseNumberStateCode": "VT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LN0000X",
          "TaxonomyName": "Neonatal Nurse Practitioner",
          "LicenseNumber": "2671445",
          "LicenseNumberStateCode": "ID",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LN0005X",
          "TaxonomyName": "Critical Care Neonatal Nurse Practitioner",
          "LicenseNumber": "SP012272",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LN0005X",
          "TaxonomyName": "Critical Care Neonatal Nurse Practitioner",
          "LicenseNumber": "137875",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LN0005X",
          "TaxonomyName": "Critical Care Neonatal Nurse Practitioner",
          "LicenseNumber": "5012691",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LN0005X",
          "TaxonomyName": "Critical Care Neonatal Nurse Practitioner",
          "LicenseNumber": "CNP01795",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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